Bile duct cancer is when abnormal cells in the bile ducts start to divide and grow in an uncontrolled way. The cells can eventually grow into surrounding healthy tissues or organs such as the gallbladder or pancreas, and may spread to other areas of the body.
Bile duct cancer is also called cholangiocarcinoma (pronounced kol-an-gee-oh-car-sin-oh-ma).
The gallbladder is a small organ tucked under the liver. It is a small, hollow pouch about 8cm long and 2.5cm wide and is connected to the liver and bowel by a series of tubes known as the bile ducts.
The liver makes bile which helps to break down fats from food. The gallbladder stores the bile until there are fats in the bowel that need digesting. Bile can also pass directly to the bowel from the liver. A sphincter controls the release of bile into the bowel.
Cancer of the gallbladder and bile ducts are rare in the UK. They are called biliary cancers.
Bile duct cancers are divided into 3 types depending on where they develop. Intrahepatic bile duct cancer forms inside the liver. Perihilar bile duct cancer forms just outside the liver where the right and left hepatic ducts meet. And distal bile duct cancer forms in the bile ducts that go through the pancreas to the small bowel.
Lymph nodes surround these organs and make up part of our immune system, helping us fight infections. They are often the first place cancer cells reach when they break away from a tumour.
For information about gallbladder and bile duct cancers go to cruk.org/cancer-types
The bile ducts
The bile ducts are part of the digestive system. They are the tubes that connect the liver and gallbladder to the small bowel. The bile ducts carry bile. This is a fluid that helps to digest food by breaking down fat. The liver makes bile which is stored in the gallbladder.
There are two main bile ducts in the liver – the right and left hepatic ducts. They join just outside the liver to form the common hepatic duct.
Another bile duct comes from the gallbladder. This is called the cystic duct.
The hepatic duct and cystic duct join together to form the common bile duct.
The common bile duct passes behind the pancreas and joins the pancreatic duct. The combined ducts open into the small bowel, where bile is released. The release of bile is controlled by a valve.
When we eat, the gallbladder releases bile into the small bowel to help digest food.
Where bile duct cancer develops
Doctors divide bile duct cancers into 3 groups depending on where they develop:
- intrahepatic region – this means within the liver and includes the right and left hepatic ducts and their smaller branches
- perihilar (hilar) region – this is just outside the liver where the right and left hepatic ducts meet
- distal region – this includes the bile ducts that run through the pancreas to the small bowel
Cancers that start in the bile ducts outside the liver are called extrahepatic bile duct cancers.
How common is bile duct cancer
In the UK around 1,900 people are diagnosed each year with intrahepatic bile duct cancer. Around 530 people are diagnosed with extrahepatic bile duct cancer.
The number of people getting bile duct cancer has slowly increased in the last few years. It is more common in men than women. Your risk of getting bile duct cancer increases as you get older. Most people who develop it are over 65.